VA Testimony of Jack McCoy before Congress on March 16, 2006

STATEMENT OF JACK MCCOY
ASSOCIATE DEPUTY UNDER SECRETARY
FOR POLICY AND PROGRAM MANAGEMENT
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
SUBCOMMITTEE ON DISABILITY AND MEMORIAL AFFAIRS
HOUSE COMMITTEE ON VETERANS' AFFAIRS

Mr. Chairman and members of the Subcommittee, I appreciate the opportunity to appear before you today to discuss VA's efforts to reach out to servicemembers, veterans, and their survivors and make them aware of the full range of benefits and services to which they may be entitled. In addition to highlighting our various outreach activities, I will also testify about VBA's efforts to improve the quality of service we provide to telephone callers who contact the Veterans Benefits Administration (VBA) regional offices. I will specifically address the actions that we have taken as a result of the "mystery caller" study, which was an internal quality improvement initiative.

Since November 2004, everyone inducted into the five military branches receives a VA benefits pamphlet at the Military Entrance Processing Station. This pamphlet provides inductees with basic information on VA benefits and services at the start of their military active service. We want to be sure they know that VA will be there for them in the future.

Transition Assistance Program (TAP) briefings, other military services briefings, and personal interviews conducted by VBA representatives continue to increase each year, as indicated in the chart below. These include briefings conducted for regular active duty military members; pre- and post-deployment briefings for Reserve and National Guard members; and briefings conducted overseas in England, Germany, Italy, Japan, Okinawa, Korea, Bahrain, and Guantanamo Bay.

*Fiscal Year*	*Briefings*	*Attendees*	*Interviews*
2003	5,840	210,015	102,402
2004	7,834	276,574	122,120
2005	8,184	326,664	124,092
2006 (through 12/31/05)	1,264	65,218	8,853

Through VA's DTAP briefings, VBA advises transitioning servicemembers about the benefits available through VBA's Vocational Rehabilitation and Employment Program. Standardized information on the VR&E Program is provided through formal briefings, booklets, videos, and interviews to veterans with service-connected disabilities seeking suitable employment or independent living.

In peacetime, outreach to Reserve and National Guard members is generally accomplished on an "on call" or "as requested" basis. But, with the onset of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) and the activation and deployment of large numbers of Reserve and National Guard members, VBA's outreach to this group has been greatly expanded. Benefits briefings for Guard and Reserve members increased from 821 briefings for more than 46,000 attendees in FY 2003 to nearly 2,000 briefings for more than 118,000 attendees in FY 2005.

Recently, VA and the National Guard Bureau teamed up to train newly hired State Benefits Advisors (SBAs) and ensure a smooth and seamless transition for Guard members returning from active-duty deployments. The states hired 54 new National Guard SBAs who are themselves recently returned veterans. They recently completed a special training program at the Veterans Benefits Administration Academy in Baltimore to increase their knowledge of VA benefits and services, including medical benefits. Now these SBAs are available to educate fellow combat veterans on the many benefits to which they may be entitled.

Since 2003, VA has assigned veterans service representatives at key MTFs where severely wounded OEF/OIF servicemembers are frequently sent. These representatives educate servicemembers and their families on VA benefits and services, and assist with filing disability compensation claims and claims for vocational rehabilitation and employment services. Full-time staff are assigned to the Walter Reed Army Medical Center and the Bethesda Naval Medical Center. Similar teams work with patients and family members at Eisenhower (Ft. Gordon, GA), Brooke (Ft. Sam Houston, TX), and Madigan (Tacoma, WA) Army Medical Centers; Evans (Ft. Carson, CO) and Darnall (Ft. Hood, TX) Army Community Hospitals; and Camp Pendleton and Balboa Naval Hospitals (CA). VBA coordinators also provide itinerant service at other MTFs. As of January 2006, more than 8,400 hospitalized OEF/OIF servicemembers from the major MTFs have been assisted through this arrangement.

In concert with the military services outreach program, VBA continues its Benefits Delivery at Discharge (BDD) Program through which servicemembers can apply for service-connected disability compensation within 180 days of discharge. The required physical examinations are conducted, service medical records are reviewed, and a preliminary rating decision is prepared prior to or shortly after discharge so that benefits can be awarded shortly after discharge. Currently 140 military installations participate in this program, including two sites in Germany and three in Korea. The number of BDD claims received by VA has increased from almost 26,000 in FY 2003 to more than 46,000 in FY 2005.

The Veterans Assistance at Discharge System (VADS) generates a "Welcome Home Package" for all recently separated veterans (including Reserve and National Guard members) that contains a letter from the Secretary, along with pamphlets describing VA benefits and services and a benefits timetable. VADS also sends separate packages that explain Education, Loan Guaranty, and Insurance benefits. In addition to the VADS mailings, a separate personal letter from the Secretary, along with benefits information, is sent to each returning OEF/OIF veteran.

In February 2003, VBA enhanced its national outreach efforts to assist FPOWs. Regional offices contacted FPOWs who were not receiving compensation or were receiving compensation for disabilities rated 50 percent or less. In June 2003, this outreach initiative was expanded to include about 9,500 FPOWs who were recently identified as FPOWs in our system or who were rated less than 100% disabled. This outreach program produced 356 original and 1,183 reopened claims. A pamphlet describing benefits for FPOWs was developed to support this outreach effort and continues to be distributed during FPOW outreach events.

During FY 2004, a coordinated nationwide outreach campaign was conducted for FPOWs in the news media. VBA also activated a totally redesigned website devoted to FPOW issues and programs.

During 2005, VA contacted nearly 21,000 FPOWs or their survivors to make them aware of two new conditions (heart disease and stroke) added to the list of conditions presumed to be the result of POW captivity. In 626 cases, FPOWs who had been previously rated as non service-connected for heart disease or stroke were granted service connection for these conditions. Another 556 survivors were granted Dependency and Indemnity Compensation (DIC).

VBA reaches out to low-income and elderly veterans and surviving spouses to make them aware of their potential entitlement to pension benefits. VBA outreach coordinators routinely participate in events where low-income and elderly veterans and surviving spouses gather, such as senior citizen centers, nursing homes, and senior day care centers. Relationships have been established with local agencies on the aging, Social Security Administration (SSA) offices, and other agencies and organizations that come into contact with older Americans.

During FY 2002, VA joined with SSA in a national outreach effort to advise SSA public contact employees about VA benefits and services. VBA distributed 2 million copies of benefits pamphlets to more than 1,300 SSA offices nationwide. The pamphlet was distributed in both English and Spanish. Regional offices contacted the local SSA offices in their jurisdiction to ensure that systems were in place to refer veterans and their spouses between the two agencies. A December 2005 revision to the pamphlet is currently being produced and will again be distributed to SSA offices.

VBA continues to work closely with VHA and the National Cemetery Administration to ensure benefits information is made available at key customer service points, such as the waiting areas of medical facilities and at national cemeteries. We have new initiatives underway that will include providing information about pension benefits in the Enrollment Welcome Letters sent to lower income veterans that are being enrolled for Category 5 health care benefits. We are also continually strengthening our relationships with agencies that come into contact with individuals who may be eligible for pension, such as Department of Health and Human Services, AARP, and national funeral directors.

As part of Public Law 107-95, VBA established full or part-time Homeless Veterans Outreach Coordinators (HVOCs) at all 57 regional offices. The HVOCs routinely meet with representatives from various Federal agencies, service organizations, associations, and other groups that are involved in homeless veterans programs, to learn more about programs that homeless veterans may access. HVOCs continue to actively participate in "stand downs" for homeless veterans. Stand downs are typically one to three day events providing food, shelter, clothing, health screenings, VA and Social Security benefits counseling, and referrals to a variety of other services, such as housing, employment, and substance abuse treatment.

Women Veterans. Women Veterans Coordinators at regional offices continue to work closely with their counterparts in the Veterans Health Administration and Vet Centers, as well as with local service organization representatives. Through such partnering, local outreach events have been expanded to regional activities such as the annual Women Veterans Appreciation Day in Branson, Missouri. VBA representatives at the national and local levels continue to work with the Center for Women Veterans, the VHA Women Veterans Health Program, and the Secretary's Advisory Committee on Women Veterans, to improve outreach to women veterans.

Native American Veterans. VBA outreach coordinators have participated in VA benefits briefings on reservations and meetings with local Native American groups. In FY 2002, working with the Center for Minority Veterans, VBA developed benefits training for Tribal Veterans Representatives who are designated by tribal officials to serve as a point of contact for tribal veterans. They are valuable resources for information on VA benefits and services. Through this program, 35 Tribal Veterans Representatives from Montana and Wyoming received comprehensive training on VA benefits and services, including the compensation claims process and health care enrollment. This program will expand to other states in FY 2006.

Vietnam Veterans Exposed to Agent Orange: The major ongoing outreach initiative for veterans who served in-country Vietnam is the Agent Orange Review newsletter, published two to three times annually by the Veterans Health Administration (VHA) in partnership with VBA. It is mailed to approximately 600,000 in-country Vietnam veterans to update them on new medical studies, changes in benefits, and related matters. The Agent Orange Helpline continues to operate with more than 7,000 calls received in FY 2005.

Gulf War Veterans: Outreach to Gulf War veterans who served in the Southwest Asia Theater of Operations during the period of August 2, 1990 to July 31, 1991 is mainly accomplished through the Gulf War Review newsletter, which is issued three to four times annually and mailed to about 220,000 individuals. It contains information about Gulf War-related issues and new legislation. A special Gulf War Helpline also supports Gulf War veterans with information and assistance.

Project 112/SHAD (Project Shipboard Hazard & Defense): VA continues to mail outreach letters to veterans who participated in Project 112 tests during the 1960s and early 1970s.

Mustard Agents and Lewisite (Mustard Gas): VA continues to reach out to veterans identified as being exposed to mustard gas or Lewisite, and we continue to make efforts to obtain Social Security numbers and current addresses for any remaining veterans who may not yet have received them.

First Time Applicants: Per Public Law 107-103, Section 304, all veterans who first apply for any VA benefit must be informed about other potential benefits. Upon receipt of compensation, pension, and education claims, VA field stations send out pamphlets describing other VA benefits. Veterans who receive an award letter for disability compensation benefits also receive an information sheet describing other VA benefits and services. Veterans and surviving spouses using home loan guaranty benefits are also mailed a copy of a pamphlet at the time of loan closure that provides a summary of VA benefits.

Casualty Assistance Officers (CAOs) from VA regional offices visit family members of servicemembers who died on active active duty to assist them in applying for Dependency and Indemnity Compensation benefits. These visits are coordinated with the military CAOs. A special brochure that outlines benefits and services for survivors of servicemembers is provided. The benefits application process is streamlined through the use of a simplified one-page application form that is faxed to the VA Regional Office and Insurance Center in Philadelphia. All of these claims are processed within 48 hours of receipt of required documents. Because family members are in an acute stage of grief during the initial visit, a six-month follow-up letter is sent to ensure that surviving spouses and dependent children are aware of the full range of benefits available to them.

In 2005, VBA participated in a joint agency effort with the Department of Defense to create a single point of access to benefits information specific to survivors of OEF/OIF servicemembers. A new web site was launched in July 2005 that offers users a choice of information for survivors of servicemembers who died while on active duty, or survivors of veterans who died as a result of a service-connected disability. Almost 241,000 visitors have accessed the site to date.

As required by Public Laws 107-14, Section 6 (Outreach to Eligible Dependents) and 107-103, Section 304 (Improvement of Veterans Outreach Programs), VA has developed pamphlets describing potential benefits. These are mailed out by the regional offices to approximately 600,000 survivors a year that apply for a United States Flag for burial purposes. A benefits pamphlet is also sent to all dependents and survivors who file original claims for DIC, Death Pension, Dependents' Educational Assistance, and Life Insurance.

VA's Office of Policy, Planning, and Preparedness is currently conducting a survey as required by Public Law 108-454, the Veterans Benefits Improvement Act of 2004, sec. 805. The survey will be the basis for a report on servicemembers' and veterans' awareness of benefits and services available under laws administered by Secretary of VA. Once the final report is submitted, VBA will work closely with the Office of Policy, Planning, and Preparedness to ensure that outreach enhancements are implemented accordingly. A draft of the report is anticipated to be delivered in July 2006.

VA regional office employees provide direct services to veterans and their family members. These employees are part of public contact teams responsible for outreach, fiduciary activities, and direct contacts through telephone calls and face-to-face interviews. In FY 2005, we handled more than 6.3 million phone calls and conducted more than 1 million interviews.

Although VBA has had a local quality review process in place for many years that involves silent monitoring of calls by regional office management, a more broadbased internal quality improvement initiative known as the "mystery caller" study was undertaken by VBA. It was intended to assess the completeness and accuracy of the information provided to phone inquiries that are not related to a specific claim. While the findings of this internal review were disappointing, they have been a catalyst for actions to improve the quality of our telephone services.

A letter, with an attached summary of some of the actions we have taken as a result of the "mystery caller" study, was sent to the subcommittee on February 10, 2006. As stated in the letter, VBA will continue to strengthen field guidance, oversight, and accountability systems in this area. We are also expanding the training resources available to our employees and providing better information systems and tools. Completion of an on-line reference system to help employees provide complete and accurate information is will be available by the end of the year.

The Under Secretary for Benefits has communicated an expectation to all regional office directors that immediate and significant improvements will be realized, and that regional office leaders will become personally involved in local telephone quality oversight and improvement efforts. In addition, all public contact employees will use the furnished training tools.

We are implementing a national telephone quality assurance program that we successfully piloted last year. This program allows us to centrally monitor all types of calls to our system, instead of just assessing responses to "staged" general information calls by "mystery callers." It will also enable us to provide more immediate feedback and training to employees and their supervisors, which the pilot demonstrated can significantly and rapidly improve quality.

We are upgrading our telecommunications technologies to implement centralized quality monitoring of our national toll-free telephone network. We are beginning this centralized monitoring of regional offices as the systems are upgraded. By the end of 2006, we will have the necessary technology installed to enable us to silently monitor 28 regional offices across the country. We will then be able to establish a quality baseline for telephone services and develop regional office and national goals for performance improvement. We are also accelerating plans to acquire the technology to expand to the remaining regional offices.

We must provide complete and accurate information to all those who call us for assistance - and our assistance must be offered with courtesy, understanding, and professionalism. This is, and will remain, a top priority for the entire VBA organization.

Mr. Chairman, this concludes my testimony. I will be happy to respond to any questions that you or other members of the Subcommittee might have.